Colovesical Fistula*

Abstract

Twenty‐four geriatric patients with colovesical fistula were admitted to St. Vincent's Hospital, New York, between January 1961 and December 1970. A review of these cases showed that only 42 per cent were correctly diagnosed upon admission. Diverticulitis was the leading etiologic factor, and in most cases the fistula was located between the sigmoid and the bladder. The most valuable diagnostic procedures were cystoscopy and barium‐enema x‐ray examination. Pneumaturia (present in 75 per cent of the cases) and fecaluria were significant physical findings, as was abdominal pain. A three‐stage operation — preliminary colostomy, then colonic resection and fistulectomy, and finally closure of the colostomy — is the safest surgical procedure.

CT in the diagnosis of enterovesical fistulae

“…Carcinoma of the colon is the second most frequent cause [2, 7, 9, 1 1 ]. Most colonic fistulae arise from the rectosigmoid, the cecum being a less common site [9,14]. 10,17], the Bourne test [1 9], and the use of charcoal have failed to gain wide acceptance.…”

Positive outcomes with neoadjuvant chemotherapy in the management of colovesical fistula in cancer: a case report and literature review

“…About two-thirds of CVFs develop from colonic diverticulitis, and other causes include colorectal tumors, bladder tumors, Crohn’s disease, radiation therapy, and trauma ( Zizzo et al, 2022 ). Fistulas occur most often between the sigmoid colon and the bladder ( Steier et al, 1973 ; Larsen et al, 1996 ; Kobayashi et al, 2003 ). The initial symptoms of CVF are usually related to the urinary tract, such as pneumaturia, fecaluria, and urinary tract infection symptoms ( Steier et al, 1973 ; Zizzo et al, 2022 ).…”

“…Fistulas occur most often between the sigmoid colon and the bladder ( Steier et al, 1973 ; Larsen et al, 1996 ; Kobayashi et al, 2003 ). The initial symptoms of CVF are usually related to the urinary tract, such as pneumaturia, fecaluria, and urinary tract infection symptoms ( Steier et al, 1973 ; Zizzo et al, 2022 ).…”

“…In patients with operable CVF, surgery is traditionally performed in one, two, or three stages ( Steele et al, 1979 ; Ashrafi and Sotelo, 2019 ; Zizzo et al, 2022 ; Xu et al, 2023 ). In 1973, Steier et al ( Steier et al, 1973 ) proposed that it was safer to complete the operation in three stages, that is, proximal colostomy was performed first, followed by colectomy, fistula resection and bladder repair, and finally colostomy closure. However, for tumor patients, the occurrence of CVF means that it is already in the local advanced stage, and radical resection is difficult.…”

“…CVFs often develop from colonic diverticulitis, followed by tumors ( Zizzo et al, 2022 ). Fistulas mostly form between the sigmoid colon and the bladder ( Steier et al, 1973 ; Larsen et al, 1996 ; Kobayashi et al, 2003 ). Due to anatomical differences, CVFs are more common in males, while in females, the occurrence of CVFs is often associated with cervical cancer ( Chen et al, 2010 ).…”